What will EHR vendor Epic Systems and its Philadelphia-based customer Jefferson Health look like together in 2024, when Thomas Jefferson University celebrates turning 200 years old?
That was the thought-providing question David Nash, M.D., M.B.A, dean of Jefferson’s College of Population Health, put to Epic CEO Judy Faulkner on May 9, soon after she had finished delivering the 27th Annual Raymond C. Grandon Lecture at Jefferson.
In her lecture, Faulkner had mentioned that she tends to think in generational terms rather than with a short-term vision about of the future.
Noting that five years from now is not that far away, she responded that there will continue to be concern about where care is going. “Is it going to the strip malls? Are the things that are profitable for you being taken away and leaving you with things that are hard and unprofitable?” she asked. “We will still be figuring out how to meet government regulations and still thrive. I don’t think it is going to be all that different in terms of technology. There will be an emphasis on trying to get to ambient voice.”
Nash asked her to elaborate on that concept a bit. “In the exam room, you could be talking with a patient and the microphones in the room will pick up what you’re saying and placing the orders for you, putting the diagnosis in for you and basically doing your charting for you,” Faulkner said. “Those of you who use Alexa and Siri know that they don’t always get it right. Five years from now we will be a lot further along with that.”
In a panel discussion following Faulkner’s talk, Stephen Klasko, M.D., M.B.A., president and CEO of Jefferson Health, started out by mentioning that Jefferson, an Epic customer, had just achieved Stage 7, the highest recognition in the HIMSS Analytics EMR Adoption Model.
Klasko described himself as a bit more optimistic about the pace of change. “I think a few things will be different in five years. I think beyond the normal consolidation we are seeing between providers and payers, we will see a lot more vertical integration,” he said. “I personally think there will be no large health system that doesn’t have a strategically aligned payer or payers. How Epic works around that will become important. I am also more optimistic, because we have a large stake in a wearables company, that people with chronic diseases will have wearables tied to their virtual voice assistants that will send signals to Epic. And once we become ‘One Philadelphia,’ when Penn, Jefferson and Temple all have Epic, I would really hope that Epic can help us to start reducing health inequities, and start to use the resources we now have with Epic so people can start to look at how people handle their food, education and housing needs.”
Laura Jacobs, M.P.H., managing principal of GE Healthcare Partners, agreed. “Epic has a really powerful role to play in democratizing healthcare,” she said, whether it is reducing health inequities or putting healthcare in the hands of individuals, which Epic is doing now. But I think there will be more opportunities to democratize healthcare, and Jefferson’s challenge will be how to stay relevant and keep that stickiness that keeps people thinking about them as a delivery system. Epic and other technology companies will have the facilitation skills to create that relationship.”
Mouneer Odeh, M.A., vice president for enterprise analytics and chief data scientist at Jefferson, said he is intrigued by Faulkner’s description of Epic’s big data repository Cosmos, which could help offer up evidence-based decision support at the point of care. “I am very excited to learn more about it,” he said. “I think the concept of taking 200 million records and using that to create knowledge — then it truly becomes a rapid learning health system. This real-world data can offer a lot of insights. So far, we have missed the opportunity to mine that data for all of those key insights. That is one of the most exciting areas – not just predictive modeling, but taking advantage of that data commons could be extraordinarily transformative.”
During her lecture, Faulkner charmed the crowd by telling them Epic’s foundation story. She showed a picture of the little basement apartment where it started and spoke about how her background as a programmer led her to make decisions that someone with an M.B.A. would not have.
She never sought out venture capital or wanted the company to go public. Faulkner spoke about competing with Apple, Facebook and Google for talent as being one of the reasons Epic invested in its quirky campus and perks such as sabbaticals.
She also described some of the other things that make the company unusual. They hold corporate philosophy classes and teach staff members that they are “heroes helping heroes.” Epic does no budgeting, she said. The company still has only seven salespeople worldwide and they are reactive only. They do no cold calling, and the salespeople get no commissions. Every customer pays the same price, Faulkner said. They don’t wine and dine prospective customers.
The typical corporate lifecycle has an inevitable slide toward bureaucracy and a legal and financial focus, she said. She is trying to keep Epic in the earlier “stable and prime” phase. “What you put up with is what you stand for,” she said. “It can be easy to let some things slide.”
With a picture of a big deer with a huge rack of antlers on the screen, she also added the motto: “Move fast or get shot.” She said it is important to remember that you can’t take too long to make decisions.
